New Federal Report Highlights Pandemic Lessons for Nursing Homes

Federal nursing home regulators must do more to prevent staffing shortages in nursing homes and strengthen infection controls to better protect residents after the COVID-19 pandemic, which resulted in more than 185,000 residents’ deaths, a government report found.

The report was aimed at the Centers for Medicare & Medicaid Services (CMS), the agency that regulates Medicare- and Medicaid-certified nursing homes. Investigators found that training and certification requirements for nursing home aides should be reassessed, updated guidance should be given to nursing homes on how to improve infection control and a system should be created to share information on best practices among nursing homes.   

The report was released Feb. 29 by the Office of Inspector General of the Department of Health and Human Services.  ​​​

“Just because the public health emergency ended doesn’t mean we can go back to business as usual. There were long-standing problems in nursing homes that COVID exacerbated and rightfully brought to the fore,” said Rachel Bryan, the team leader for the study who is a social science analyst in the inspector general’s office, in an interview with AARP.

Bryan noted that now is the time to move from “emergency mode” to “a more reflective mode, think about what happened, face those challenges and try to implement lasting change.”

Nursing homes were not prepared for the pandemic and the report found “monumental and persistent staffing challenges,” as well as issues with infection control, she said.

Nursing home staffing shortages targeted

The agency’s report is the third in a series that examined the pandemic’s impact on nursing homes. This report provides a more in-depth look at the experiences of nursing homes during the pandemic and recommends five steps for improvement. Researchers spoke with administrators from 25 nursing homes.

Nursing homes struggled during the pandemic with staffing shortages because of high rates of turnover and burnout, the report said. They saw low worker morale, high costs of using outside staffing agencies to fill gaps, ineffective infection control practices, noncompliance on the use of personal protective equipment and low vaccination booster rates among staff, the report said.

On a positive note, the report found that nursing homes reported the initial vaccine rollout for residents and staff worked well and they received the rapid coronavirus tests provided by the government without issues.

CMS referred questions about the report to a response that Chiquita Brooks-LaSure, administrator of CMS, provided to investigators. In her response, which is included in the report, Brooks-LaSure suggested that three of five recommendations be removed from the report because the agency had implemented those changes already. She did not agree or disagree with the report’s findings in her response.